| 1 | IBRFN3 ;ALB/ARH - PASS BILL/CLAIM TO AR ;3/18/96
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| 2 | ;;2.0;INTEGRATED BILLING;**61,133,210,309**;21-MAR-94
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| 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
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| 4 | ;
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| 5 | ; Returns information on the bill passed in, all data returned in external format, for AR's RC project
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| 6 | ;
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| 7 | ; If the bill can not be found then returns ARRAY=0 (should be called with ARRAY passed by reference)
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| 8 | ; Otherwise ARRAY=1 and the following array elements may be defined
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| 9 | ; these array elements will only be defined is there is data to return
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| 10 | ; those elements that have multiple entries will be in the form ARRAY("SUB",X) where X=1:1:...
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| 11 | ;
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| 12 | ; ARRAY("BN") = BILL NUMBER
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| 13 | ; ARRAY("SR") = SENSITIVE RECORD? (Y or N)
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| 14 | ; ARRAY("STF") = STATEMENT COVERS FROM DATE - first date covered by bill
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| 15 | ; ARRAY("STT") = STATEMENT COVERS TO DATE - last date covered by bill
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| 16 | ; ARRAY("TCG") = TOTAL CHARGES^OFFSET AMT (PRIOR PAYMENTS)^OFFSET DESC
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| 17 | ; ARRAY("TOC") = BILL TYPE (INPATIENT OR OUTPATIENT)
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| 18 | ; ARRAY("TCF") = BILL FORM TYPE
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| 19 | ; ARRAY("DFP") = DATE FIRST PRINTED
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| 20 | ; ARRAY("TAX") = FEDERAL TAX NUMBER - for facility, a site parameter
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| 21 | ;
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| 22 | ; ARRAY("PIN") = DEBTOR INSURANCE NAME ^ HOSPITAL PROVIDER NUMBER ^ GROUP NAME ^ GROUP NUMBER ^
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| 23 | ; NAME OF INSURED ^ SUBSCRIBER ID ^ RELATIONSHIP TO INSURED
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| 24 | ;
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| 25 | ; ARRAY("PIN","MMA") = DEBTOR MAILING STREET ADDRESS [LINE 1] ^
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| 26 | ; MAILING STREET ADDRESS [LINE 2] ^ MAILING STREET ADDRESS [LINE 3] ^ CITY ^
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| 27 | ; STATE (ABBREVIATED) ^ ZIP ^ PHONE NUMBER
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| 28 | ;
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| 29 | ; ARRAY("RVC") = NUMBER OF REVENUE CODES ON BILL
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| 30 | ; ARRAY("RVC",X) = REVENUE CODE ^ REVENUE CODE DESCRIPTION ^ CHARGE (PER UNIT) ^ UNITS ^
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| 31 | ; TOTAL CHARGE FOR REV CODE
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| 32 | ;
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| 33 | ; ARRAY("OPV") = NUMBER OF OUTPATIENT VISIT DATES ON BILL
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| 34 | ; ARRAY("OPV",X) = OUTPATIENT VISIT DATE
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| 35 | ;
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| 36 | ; ARRAY("PRC") = NUMBER OF PROCEDURES ON BILL
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| 37 | ; ARRAY("PRC",X) = PROCEDURE CODE ^ PROCEDURE DESCRIPTION ^ PROCEDURE DATE ^
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| 38 | ; PLACE OF SERVICE CODE ^ PLACE OF SERVICE ^ TYPE OF SERVICE CODE ^ TYPE OF SERVICE
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| 39 | ;
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| 40 | ; ARRAY("DXS") = NUMBER OF DIAGNOSIS ON BILL
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| 41 | ; ARRAY("DXS,X) = DIAGNOSIS CODE ^ DIAGNOSIS
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| 42 | ;
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| 43 | ; ARRAY("RXF") = NUMBER OF PRESCRIPTION REFILLS ON BILL
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| 44 | ; ARRAY("RXF",X) = PRESCRIPTION # ^ REFILL DATE ^ DRUG NAME ^ DAYS SUPPLY ^ QUANTITY ^ NDC #
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| 45 | ;
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| 46 | ; ARRAY("PRD") = NUMBER OF PROSTHETIC ITEMS ON BILL
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| 47 | ; ARRAY("PRD",X) = PROSTHETIC DEVICE ^ DELIVERY DATE
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| 48 | ;
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| 49 | ; IF CONDITION RELATED TO EMPLOYMENT: ARRAY("CRE") = "EMPLOYMENT"
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| 50 | ; IF CONDITION RELATED TO AN AUTO ACCIDENT: ARRAY("CRA") = "AUTO ACCIDENT" ^ STATE (ABBREVIATION)
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| 51 | ; IF CONDITION RELATED TO AN OTHER ACCIDENT: ARRAY("CRO") = "OTHER ACCIDENT"
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| 52 | ;
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| 53 | BILL(IBIFN,ARRAY) ; returns array of information on a specific bill, based on RC requirements
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| 54 | ;
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| 55 | N IBI,IBJ,IBK,IBX,IBY,IBTMP,IBD0,IBDU,IBDU1,IBDI1,IBDS,IBDATE
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| 56 | K ARRAY S ARRAY=1 I '$G(IBIFN)!($G(^DGCR(399,+$G(IBIFN),0))="") S ARRAY=0 Q
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| 57 | F IBI=0,"U","U1","S" S @("IBD"_IBI)=$G(^DGCR(399,IBIFN,IBI))
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| 58 | S IBX=$P(IBD0,U,21),IBX=$S(IBX="P":"I1",IBX="S":"I2",IBX="T":"I3",1:" ")
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| 59 | S IBDI1=$G(^DGCR(399,IBIFN,IBX))
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| 60 | ;
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| 61 | S ARRAY("TCG")=$P(IBDU1,U,1,3)
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| 62 | S ARRAY("BN")=$P(IBD0,U,1)
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| 63 | S ARRAY("SR")=$S($P(IBDU,U,5)=1:"Y",1:"N")
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| 64 | S ARRAY("STF")=$P(IBDU,U,1)
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| 65 | S ARRAY("STT")=$P(IBDU,U,2)
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| 66 | S ARRAY("TOC")=$S($P(IBD0,U,5)<3:"INPATIENT",1:"OUTPATIENT")
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| 67 | S ARRAY("TCF")=$$FTN^IBCU3($$FT^IBCU3(IBIFN))
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| 68 | S ARRAY("DFP")=$P(IBDS,U,12)
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| 69 | S ARRAY("TAX")=$P($G(^IBE(350.9,1,1)),U,5)
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| 70 | ;
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| 71 | INS ; insurance information
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| 72 | S IBX=$G(^DGCR(399,+IBIFN,"M"))
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| 73 | S ARRAY("PIN")=$P(IBX,U,4)_U_$P($G(^DIC(36,+IBDI1,0)),U,11)_U_$P(IBDI1,U,15)_U_$P(IBDI1,U,3)_U_$P(IBDI1,U,17)_U_$P(IBDI1,U,2)_U_$$RTI($P(IBDI1,U,16))
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| 74 | S ARRAY("PIN","MMA")=$P(IBX,U,5)_U_$P(IBX,U,6)_U_$P($G(^DGCR(399,+IBIFN,"M1")),U,1)_U_$P(IBX,U,7)_U_$$STATE($P(IBX,U,8))
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| 75 | S ARRAY("PIN","MMA")=ARRAY("PIN","MMA")_U_$$ZIP($P(IBX,U,9))_U_$P($G(^DIC(36,+IBDI1,.13)),U,1)
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| 76 | ;
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| 77 | RC ; revenue codes
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| 78 | S (IBI,IBJ)=0,ARRAY("RVC")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"RC",IBI)) Q:'IBI D
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| 79 | . S IBX=$G(^DGCR(399,IBIFN,"RC",IBI,0)) Q:IBX="" S IBY=$G(^DGCR(399.2,+IBX,0))
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| 80 | . S IBJ=IBJ+1,ARRAY("RVC")=IBJ
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| 81 | . S ARRAY("RVC",IBJ)=$P(IBY,U,1)_U_$P(IBY,U,2)_U_$P(IBX,U,2)_U_$P(IBX,U,3)_U_$P(IBX,U,4)
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| 82 | ;
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| 83 | OPV ; outpatient visit dates
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| 84 | S (IBI,IBJ)=0,ARRAY("OPV")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"OP",IBI)) Q:'IBI D
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| 85 | . S IBX=$G(^DGCR(399,IBIFN,"OP",IBI,0)) Q:'IBX
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| 86 | . S IBJ=IBJ+1,ARRAY("OPV")=IBJ
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| 87 | . S ARRAY("OPV",IBJ)=+IBX
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| 88 | ;
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| 89 | PRC ; procedure codes
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| 90 | S (IBI,IBJ)=0,ARRAY("PRC")=IBJ F S IBI=$O(^DGCR(399,IBIFN,"CP",IBI)) Q:'IBI D
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| 91 | . S IBX=$G(^DGCR(399,IBIFN,"CP",IBI,0)),IBY=""
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| 92 | . S IBDATE=$P(IBX,U,2) I 'IBDATE S IBDATE=$$BDATE^IBACSV(IBIFN)
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| 93 | . S IBY=$P($$PRCD^IBCEF1($P(IBX,U),1,IBDATE),U,2,3)
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| 94 | . Q:$P(IBY,U)=""
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| 95 | . S IBJ=IBJ+1,ARRAY("PRC")=IBJ
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| 96 | . S ARRAY("PRC",IBJ)=IBY_U_$P(IBX,U,2)
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| 97 | . S IBY=$G(^IBE(353.1,+$P(IBX,U,9),0)),ARRAY("PRC",IBJ)=ARRAY("PRC",IBJ)_U_$P(IBY,U)_U_$P(IBY,U,3)
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| 98 | . S IBY=$G(^IBE(353.2,+$P(IBX,U,10),0)),ARRAY("PRC",IBJ)=ARRAY("PRC",IBJ)_U_$P(IBY,U)_U_$P(IBY,U,3)
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| 99 | ;
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| 100 | DX ; diagnosis codes
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| 101 | K IBTMP D SET^IBCSC4D(IBIFN,"",.IBTMP)
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| 102 | S IBDATE=$$BDATE^IBACSV(IBIFN)
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| 103 | S (IBI,IBJ)=0,ARRAY("DXS")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
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| 104 | . S IBX=IBTMP(IBI),IBY=$$ICD9^IBACSV(+IBX,IBDATE) Q:IBY=""
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| 105 | . S IBJ=IBJ+1,ARRAY("DXS")=IBJ
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| 106 | . S ARRAY("DXS",IBJ)=$P(IBY,U)_U_$P(IBY,U,3)
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| 107 | ;
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| 108 | RX ; prescription refills
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| 109 | K IBTMP D SET^IBCSC5A(IBIFN,.IBTMP)
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| 110 | S (IBI,IBJ)=0,ARRAY("RXF")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
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| 111 | . S IBK=0 F S IBK=$O(IBTMP(IBI,IBK)) Q:'IBK D
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| 112 | .. S IBX=IBTMP(IBI,IBK) D ZERO^IBRXUTL(+$P(IBX,U,2)) S IBY=$G(^TMP($J,"IBDRUG",+$P(IBX,U,2),.01))
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| 113 | .. S IBJ=IBJ+1,ARRAY("RXF")=IBJ
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| 114 | .. S ARRAY("RXF",IBJ)=IBI_U_IBK_U_IBY_U_$P(IBX,U,3)_U_$P(IBX,U,4)_U_$P(IBX,U,5)
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| 115 | .. K ^TMP($J,"IBDRUG")
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| 116 | .. Q
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| 117 | ;
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| 118 | PD ; prosthetic items
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| 119 | K IBTMP D SET^IBCSC5B(IBIFN,.IBTMP)
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| 120 | S (IBI,IBJ)=0,ARRAY("PRD")=IBJ F S IBI=$O(IBTMP(IBI)) Q:'IBI D
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| 121 | . S IBK=0 F S IBK=$O(IBTMP(IBI,IBK)) Q:'IBK D
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| 122 | .. S IBX=IBTMP(IBI,IBK)
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| 123 | .. S IBJ=IBJ+1,ARRAY("PRD")=IBJ
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| 124 | .. S ARRAY("PRD",IBJ)=$P($$PIN^IBCSC5B(IBK),U,2)_U_IBI
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| 125 | ;
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| 126 | CC ; condition related to employment, auto accident (place), other accident
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| 127 | S IBI=0 F S IBI=$O(^DGCR(399,IBIFN,"CC",IBI)) Q:'IBI I $G(^(IBI,0))="02" S ARRAY("CRE")="EMPLOYMENT"
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| 128 | S IBI=0 F S IBI=$O(^DGCR(399,IBIFN,"OC",IBI)) Q:'IBI S IBX=$G(^(IBI,0)) I +IBX D
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| 129 | . S IBY=$G(^DGCR(399.1,+IBX,0)) Q:IBY=""
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| 130 | . I $P(IBY,U,9)=1 S ARRAY("CRE")="EMPLOYMENT"
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| 131 | . I $P(IBY,U,9)=2 S ARRAY("CRA")="AUTO ACCIDENT"_U_$$STATE($P(IBX,U,3))
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| 132 | . I $P(IBY,U,9)=3 S ARRAY("CRO")="OTHER ACCIDENT"
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| 133 | Q
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| 134 | ;
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| 135 | STATE(X) ; returns 2 letter abbreviation for state
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| 136 | Q $P($G(^DIC(5,+X,0)),U,2)
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| 137 | ZIP(X) ; returns zip in external form
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| 138 | S X=$E(X,1,5)_$S($E(X,6,9)]"":"-"_$E(X,6,9),1:"")
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| 139 | Q X
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| 140 | RTI(X) ; returns external form of relationship to insured
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| 141 | I X'="" S X=$S(X="01":"PATIENT",X="02":"SPOUSE",X="03":"NATURAL CHILD",X="08":"EMPLOYEE",X="09":"UNKNOWN",X="11":"ORGAN DONOR",X="15":"INJURED PLANTIFF",X="18":"PARENT",1:"")
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| 142 | Q X
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| 143 | ;IBRFN3
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